Elba Express Company, L.L.C.

Original Volume No. 1

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Effective Date: 03/01/2010, Docket: RP10-342-000, Status: Effective

Original Sheet No. 116 Original Sheet No. 116

 

GENERAL TERMS AND CONDITIONS

APPENDIX C

EEC AND CUSTOMER CONTACT INFORMATION

COMPLETE ALL THE REQUESTED INFORMATION.

NOTE: CUSTOMER IS RESPONSIBLE FOR UPDATING

CONTACT INFORMATION

 

Customer's Legal Name: ______________________________________________________

 

Trade Name: _________________________________________________________________

 

Duns Number: ________________________________________________________________

 

Federal Tax ID: _____________________________________________________________

 

Tel. Number: ________________________________________________________________

 

Fax Number: _________________________________________________________________

 

E-mail: _____________________________________________________________________

 

24-Hour Emergency Telephone or Cell No.: ___________________________________

 

Type of Legal Entity: ______________________________________________________

 

(If Corporation, State of Incorporation):____________________________________

 

Shipper is: ________a local distribution company (LDC) (Code 1)

________an interstate pipeline (Code 2)

________an intrastate pipeline (Code 3)

________an end-user (Code 4)

________a producer (Code 5)

________a marketer/broker (Code 6)

________pipeline sales operating unit (Code 7)

________other (fill in) (Code 8)

 

Is Customer affiliated with EEC? Yes _________ No ___________

Mailing Address: _____________________________________________

City: _____________ State: ______ Zip: _______________

Street Address: ________________________________________

City: __________ State: ______ Zip: ______________________

Bills to be sent to the attention of: _________________________

(If the Billing Contact above is a person, please fill out this person's contact info. on

Page 2, checking the Billing Contact Type)

Billing Address (if different from above mailing address):

(To be used if e-billing is unavailable)

P.O. Box: _____________________________________________________

City: ______________ State: ______ Zip: ________________

Name of Contract Administrator (if applicable): ________________